PD04-07: Analysis of high-risk factors for adrenal crisis after adrenal surgery

Quanliang Liu, Yuhua Zou, Xiaofeng Zou*, Guoxi Zhang, Yuanhu Yuan, Rihai xiao, Gengqing Wu, Biao Qian, Xiaoning Wang, Hui Xu, Ganzhou, China, People's Republic of

Introduction: To summarize the clinical characteristics, diagnosis and treatment experience of secondary adrenal crisis after adrenal tumor resection, and to explore its related risk factors.

Methods: The clinical data of 235 patients undergoing adrenal tumor resection in the Department of Urology of the First Affiliated Hospital of Gannan Medical University from January 2015 to April 2021 were retrospectively analyzed. Logistic regression was used to analyze the related risk factors of adrenal crisis after adrenalectomy.This study was approved by the Hospital Ethics Committee.

Results: The age ranged from 21 to 65 years ( mean 47 years ). 136 males and 99 females. Among them, 149 cases underwent retroperitoneal laparoscopic adrenalectomy, 69 cases underwent transabdominal laparoscopic adrenalectomy, and 17 cases underwent robot-assisted laparoscopic adrenalectomy. Among them, 80 cases were cortisol adenoma, 4 cases were adrenalcortical carcinoma, 115 cases were aldosterone adenoma, 26 cases were pheochromocytoma, and 10 cases were bilateral adrenal cortical hyperplasia. The diameter of the tumor was 1.5-11 cm, including 16 patients with adrenal crisis ( 9 males and 7 females). Logistic regression analysis showed that age, tumor size, operation side, operation mode, operation time and intraoperative blood loss had no significant correlation with the occurrence of adrenal crisis. Preoperative infection, adrenal cortical tumor, preoperative ACTH level, preoperative blood glucose abnormality, intraoperative non-preventive corticosteroids and previous history of adrenal crisis were high risk factors for adrenal crisis after adrenal tumor operation.

Conclusions: Adrenal crisis is more likely to occur after adrenal tumor resection in patients with preoperative infection, adrenal cortical tumors and low levels of ACTH, diabetes and previous history of adrenal crisis. Postoperative vital signs should be closely observed and hormones should be supplemented in time to avoid adverse events.

Source of Funding: National Natural Science Foundation of China (81860456, 81760462)